Fear, Uncertainty and Doubt: David Seymour and the Experts

I recently attended a Health Central debate in Wellington on
the End of Life Choice Bill (full debate online). Among the
panellists were David Seymour and a visiting Canadian
doctor, Dr Leonie Herx. Dr Herx, President of the Canadian
Society of Palliative Care Physicians, had come out to New
Zealand to describe her experiences with the Canadian
euthanasia legislation that was passed two years ago. And,
frankly, to warn us off doing the same thing.

Dr Herx
detailed serious concerns about her ‘on the ground’
experience of euthanasia. These issues include
failed/ignored safeguards (similar to those in the NZ Bill),
limited data collection, coercion of doctors and
institutions, expanding eligibility, and the use of
palliative care funding to facilitate euthanasia.

Mr
Seymour’s routine response to overseas documented failures
has been to brush them off as ‘fear-mongering’, and the
‘spreading of lies and misinformation’, or ‘fear,
uncertainty, and doubt’. It’s patronising and
dismissive. Of course he’s not going to agree with all of
their concerns. But he tends towards broad-sweep rebuttals,
glossing over the complexities and nuances that make
euthanasia a complex issue.

In the face of
well-documented problems in jurisdictions such as the
Netherlands, Belgium and Canada, he also continues to claim
that ‘it is possible to to design legislation that gives
safety and protection to those who want nothing to do with
it and choice to those who do’, without engaging with
practicing physicians who say that euthanasia looks far
different in practice. ‘The answer from the Canadian
Supreme Court is yes’, he said at the debate. “The lived
experience is not that’ said Dr Herx. It’s the
difference between the neatness of things on paper, and the
messiness of human activity; theoretical possibilities
versus the realities.

One of the central issues is the
widening of the criteria for euthanasia over time; it has
occurred in every jurisdiction with laws similar to what is
being proposed in Seymour’s Bill. The Canadian debate
about allowing euthanasia for mature minors is a case in
point. Why would New Zealand be any different? It is, in the
words of Dr Herx, a question of logical progression rather
than ‘slippery slopes’. We can’t just avoid the fact
that the widening of criteria will happen here, too.

When
Mr Seymour does quote figures, one has to check them
carefully. He has repeatedly said that 3.2% of people were
euthanized without their consent in Belgium in 1998 but only
1.5% in 2013, pointing to the decrease as the result of
improved regulation brought about by the legalising of
euthanasia. However, academics such as Professor Emeritus
David Richmond point out that the decrease in euthanasia
without explicit request occurred by 2001, the year
prior to the legalisation of euthanasia. Legalising
euthanasia had nothing to do with it. It is totally
disingenuous for Mr Seymour to - as Professor Richmond says
- ‘misinterpret the data for the benefit of naïve
audiences as a fall in rates and a triumph for
legalisation.’

Mr Seymour also glosses over the rise in
the numbers of people accessing euthanasia across all
jurisdictions. In a lengthy online interview in August 2017,
Mr Seymour asserts that the numbers of people accessing
euthanasia are flatlining or stabilising; but, in fact, as
the interviewer points out, the official figures indicate a
steady rise. Mr Seymour’s response is, somewhat vaguely,
‘In any case, you kind of know there’s a ceiling on it,
and you’d expect it to flatten out; with those conditions
to qualify, it is going to be limited.’ The whole exchange
is vague on Mr Seymour’s part, and there are a number of
editorial insertions to correct Mr Seymour’s statements,
and point out his errors. Mr Seymour quite simply does not
know the facts or does not want to engage with them.

So
let’s return to Dr Herx and ask ourselves why she came to
NZ. Option One: She came to fear-monger and spread lies and
misinformation. To impose fear, uncertainty, and doubt. Why
would she do that?

So let’s move to Option Two: She
genuinely had serious concerns. And those who listened
closely to Dr Herx would have all come away well aware of
these serious concerns, which deserve a serious response.
But all Mr Seymour’s could say in his eagerness to ignore
Dr Herx’s professional experience was, ‘I lived in
Canada for five years, and I know many Canadian friends, and
if you were to ask them about the version of events you have
heard from Leonie [Herx] tonight, they would wonder what on
earth you were talking about.’ That is, under the
circumstances, an astounding thing to say.

Avoidance of
the hard questions and dismissal from David Seymour is
irresponsible and patronising. At the end of the Health
Central debate, he said ‘tonight we’ve had endless
speculation, fear, uncertainty, and doubt which collapses as
soon as you go to the hard evidence of what happens
overseas.’ The laughter of the audience exposed the fact
that the reality of Dr Herx’s Canadian experience actually
pointed to the opposite conclusion. Highly experienced
clinicians don’t say ‘do not make our mistake’ on a
whim. Let’s at least offer them the respect of paying
attention to the facts.

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